University Health System Physicians, Services No Longer Available to UnitedHealthcare Insured

University Health System Physicians, Services No Longer Available to UnitedHealthcare Insured

Feb 13, 2003 5:00 PM

The University of Utah Health Systems 850-plus physicians today put UnitedHealthcare officials on notice: If United will not allow its enrollees to be treated at the University's hospitals and clinics, the doctors will not be able to continue to treat United patients.

The University of Utah Medical Group (UUMG), umbrella organization for the U physicians, notified United of its decision to terminate contracts between the insurer and U Health System doctors, effective July 1, 2003.

In December, UnitedHealthcare informed the University that its enrollees will no longer be able to choose University hospitals, clinics and affiliated facilities such as the Moran Eye Center, Huntsman Cancer Institute, and the Utah Diabetes Center for their care. Visits with UUMG doctors and procedures at these facilities will be covered by United through June 30.

The University's letter to United said the insurers decision to drop hospital facilities from its coverage creates an "untenable situation" for U physicians, ". . .undermining the clinical and academic missions of the University."

"Our doctors feel strongly that we cannot place patients in a situation that is confusing and inconvenient or that compromises the highest standard of care," said Patrick C. Cartwright, M.D., chair of UUMG's contracting and payor relations committee and associate professor of surgery at the medical school. "To tell patients they can see our doctors, but then send them elsewhere for medical tests, x-rays and hospitalization, is not the right way to give care.

"The University's reputation for excellent patient care rests, in part, on the closely coordinated working relationship between our doctors and the hospitals and clinics they have helped build. We can't be expected to turn patients away from our own front door."

Richard A. Fullmer, CEO of University of Utah Hospitals & Clinics, said the University was informed by United in late December that it will be discontinuing (as of July 1, 2003) its Wasatch Network health insurance option, which allows enrollees to select hospital coverage from the University Health System and most of the states other hospitals (excluding Intermountain Health Care [IHC] facilities). Without the Wasatch Network, United enrollees will be able to receive services primarily at IHCs facilities.

"In the University Health System, the physicians and facilities go hand in hand, and we've made that clear to UnitedHealthcare," said Fullmer. "Not only is it impractical to make available one without the other, its unfair to the tens of thousands of patients who had opted for care from physicians they trust at a medical center that is recognized as one of the top 100 in the country."

Most physician members of the University of Utah Medical Group perform the majority of their services at University facilities and University-owned community clinics. "Some of our doctors have admitting privileges at other hospitals; some don't," said Fullmer. "It is often impossible and always impractical for them to arrange for patients hospitalization and testing at distant facilities where the U plays no role in monitoring the quality of care delivered."

UnitedHealthcares decision to terminate its participation agreement with University Hospitals & Clinics affects some 160,000 insured throughout Utah.

"The United patients we have served for more than a decade and who have built comfortable, trusting relationships with our doctors will no longer have the University Health System as an affordable health-care option," said Fullmer. "Employers are also getting less than they bargained for. Six months ago, they thought participation with United Healthcare offered their employees the widest possible range of health-care options. United's actions have drastically limited those options."

The University Health System accepts most health-care plans, including Regence BlueCross BlueShield of Utah, ALTIUS Health Plans, CIGNA Healthcare, and others.